ESTRO 38 Abstract book

S314 ESTRO 38

Standardized BenchmarkRate † (95% CI)

Shortfall *

ActualProvincial Rate(95% CI)

8.8% (7.4%, 10.1%) 26.4% (24.0%, 28.8%) 14.4% (12.7%, 16.1%) 7.5% (6.2%, 8.7%)

7.3% (6.8%, 7.8%) 23.7% (23.0%, 24.5%) 12.9% (12.3%, 13.6%) 5.6% (5.2%, 6.1%)

16.8% 10.0% 10.2% 24.4%

Locoregional Bone Brain Other

Body Region

55.7% (50.5%, 60.8%) 28.4% (25.0%, 31.7%)

52.3% (50.9%, 53.7%) 22.9% (21.8%, 23.9%)

6.1% 19.4%

≤70 >70

Age

40.7% (37.8%, 43.6%) 36.2% (35.3%, 37.0%) 11.1%

Total

†PRT 5y rate among patients whose cancer was diagnosed at a hospital with RT on site, standardized to the distribution of life expectancy in the overall population; *Shortfall = Unmet Need / Total Need = (Benchmark rate - Actual rate) / Benchmark rate x 100% Figure: Inter-county variations in shortfalls in the use of PRT for breast cancer in Ontario

Conclusion The development of a RT-QI project has been demanded by the Belgian national government as a potential tool to help RT departments to further optimise the quality of patient care. Although participation of each individual department is on voluntary basis, it has been shown feasible to collect defined QIs at national level with an almost complete participation rate. The analysis and generation of benchmarking documents guide centres in their quality improvement initiatives at departmental level and support national quality improvement initiatives. OC-0598 Estimating the need for palliative radiotherapy for breast cancer: A benchmarking approach C.J. Jin 1 , W. Kong 1 , W.J. Mackillop 1 1 Queen’s Cancer Research Institute- Queen’s University, Cancer Care and Epidemiology, Kingston, Canada Purpose or Objective Palliative radiotherapy (PRT) benefits many patients with breast cancer, but optimal utilization rates remain undefined. The objective of this study was to estimate the appropriate PRT rate for the general breast cancer population. Material and Methods Ontario’s population-based cancer registry identified patients who died of breast cancer between 2009 and 2013. Multivariate analysis identified health systems factors affecting the use of PRT for breast cancer, enabling us to define a benchmark population with unimpeded access to PRT. Proportion of cases treated in the last 5 years of life (PRT 5y ) was standardized to overall population characteristics. Benchmarks were compared to province-wide PRT 5y rates. Results Overall, 36.2% of 11,075 patients who died of breast cancer between 2009 and 2013 received PRT at least once in the last 5 years of life. Availability of RT at the diagnosing hospital was the dominant determinant of increased PRT use; socioeconomic status and residential distance to nearest RT centre did not have a significant effect. Patients diagnosed at hospitals with on-site RT were therefore designated the benchmark population. The standardized benchmark for PRT 5y was 40.7%, compared to the province-wide rate of 36.2%. Indication-specific benchmarks demonstrated that shortfalls in PRT use were highest for locoregional RT, followed by brain and bone metastases (Table). Age- specific benchmarks demonstrated that shortfalls in PRT use were >3 times greater in patients >70 vs ≤70 years. The extent of the shortfall varied widely amongst Ontario regions (Figure). Table: Benchmark Rates and Shortfalls in the Use of PRT 5y

Conclusion In a standardized benchmark Ontario population with unimpeded access to RT, 40.7% of patients who died of breast cancer received PRT, compared to 36.2% of the overall population. The gap between actual and optimal PRT rates was greatest in the elderly and varied widely across regions. An effort should be made to reduce the large age-related and regional differences in PRT use for patients with advanced breast cancer. This method provides a rational estimate of appropriate treatment rates required for monitoring and improving access to cancer care. OC-0599 Survival and local control deficits due to radiotherapy under-utilisation in NSW, Australia. G. Delaney 1,2,3 , G.S. Gabriel 2,3 , J. Shafiq 2 , R. Merie 1 , S. Vinod 1,2,3 , V. Batumalai 1 , M.B. Barton 1,2 1 Liverpool Hospital, Area Cancer Services Radiation Oncology, Liverpool, Australia; 2 University of NSW,